RELIAS IV THEPARY NEWEST UPDATED FINAL EXAM WITH
COMPLETE DETAILED ANSWERS AND 100 % VERIFIED ANSWERS
WITH R ALREADY A+ GRADED
A nurse is removing a client's IV catheter. Which of the following actions should the nurse take?
A. Apply firm pressure over the vein
B. Leave the roller clamp slightly open
C. Pull the catheter straight back from the insertion site
D. Lift the hub slightly upward
C. Pull the catheter straight back from the insertion site
A nurse inserts a peripheral IV catheter and observes a blood return in the flashback chamber after
puncturing the skin and selected vein. Which of the following actions should the nurse perform next?
A. Secure the catheter to the skin with a transparent dressing
B. Advance the catheter into the vein with the finger hub
C. Release the tourniquet from the client's arm
D. Attach a primed piece of extension tubing to the catheter
B. Advance the catheter into the vein with the finger hub
,A nurse is caring for a client who is in early stage renal failure and has a prescription for the infusion of
IV fluids. Which of the following IV fluids does the nurse anticipate a prescription for and why?
A. 10% dextrose in water because it pulls fluid from the cells and increases vascular volume
B. 0.45% sodium chloride because it dilutes extracellular fluid and rehydrates the cells.
C. 0.9% sodium chloride because it replaces extracellular volume and maintains intravascular volume
D. 3% sodium chloride because it draws fluid into vessels and reduces interstitial compartments
B. 0.45% sodium chloride because it dilutes extracellular fluid and rehydrates the cells.
A nurse is caring for a client who has just had a central venous access line inserted. What action will the
nurse take next?
A. Begin the prescribed infusion via the new access.
B. Ensure that an x-ray is completed to confirm placement.
C. Check medication calculations with a second RN.
D. Make sure that the solution is appropriate for a central line.
B. Ensure that an x-ray is completed to confirm placement
,A nurse assess a client who has a radial ARTERY cathether. Which assessment will the nurse complete
first?
A. Amount of pressure in fluid container
B. Date of catheter tubing change
C. Type of dressing over the site
D. Skin color and capillary refill
D. Skin color and capillary refill
( An intra-arterial catheter may cause arterial occlusion, which can lead to absent or decreased
perfusion to the extremity.)
A nurse teaches a client who is being discharged home with a peripherally inserted central catheter
(PICC). Which statement will the nurse include in this client's teaching?
A. "Avoid carrying your grandchild with the arm that has the central catheter."
B. "Be sure to place the arm with the central catheter in a sling during the day."
C. "Flush the peripherally inserted central catheter line with normal saline daily."
D. "You can use the arm with the central catheter for most activities of daily living."
A. "Avoid carrying your grandchild with the arm that has the central catheter."
, (Rationale: A properly placed PICC (in the antecubital fossa or the basilic vein) allows the client
considerable freedom of movement. Clients can participate in most activities of daily living;
however, heavy lifting can dislodge the catheter or occlude the lumen. Although it is important to keep
the insertion site and tubing dry, the client can shower. The device is flushed with heparin.)
A nurse is caring for a client who is receiving an epidural infusion for pain management. Which
assessment finding requires immediate intervention from the nurse?
a. Redness at the catheter insertion site
b. Report of headache and stiff neck
c. Temperature of 100.1° F (37.8° C)
d. Pain rating of 8 on a scale of 0-10
b. Report of headache and stiff neck
(Rationale: Complications of epidural therapy include infection, bleeding, leakage of cerebrospinal fluid,
occlusion of the catheter lumen, and catheter migration. Headache, neck stiffness, and a temperature
higher than 101° F (37.8° C) are signs of meningitis and would be reported to the primary health care
provider immediately.)
A nurse assesses a client who had an intraosseous catheter placed in the left leg. Which assessment
finding is of greatest concern?
a. The catheter has been in place for 20 hours.
COMPLETE DETAILED ANSWERS AND 100 % VERIFIED ANSWERS
WITH R ALREADY A+ GRADED
A nurse is removing a client's IV catheter. Which of the following actions should the nurse take?
A. Apply firm pressure over the vein
B. Leave the roller clamp slightly open
C. Pull the catheter straight back from the insertion site
D. Lift the hub slightly upward
C. Pull the catheter straight back from the insertion site
A nurse inserts a peripheral IV catheter and observes a blood return in the flashback chamber after
puncturing the skin and selected vein. Which of the following actions should the nurse perform next?
A. Secure the catheter to the skin with a transparent dressing
B. Advance the catheter into the vein with the finger hub
C. Release the tourniquet from the client's arm
D. Attach a primed piece of extension tubing to the catheter
B. Advance the catheter into the vein with the finger hub
,A nurse is caring for a client who is in early stage renal failure and has a prescription for the infusion of
IV fluids. Which of the following IV fluids does the nurse anticipate a prescription for and why?
A. 10% dextrose in water because it pulls fluid from the cells and increases vascular volume
B. 0.45% sodium chloride because it dilutes extracellular fluid and rehydrates the cells.
C. 0.9% sodium chloride because it replaces extracellular volume and maintains intravascular volume
D. 3% sodium chloride because it draws fluid into vessels and reduces interstitial compartments
B. 0.45% sodium chloride because it dilutes extracellular fluid and rehydrates the cells.
A nurse is caring for a client who has just had a central venous access line inserted. What action will the
nurse take next?
A. Begin the prescribed infusion via the new access.
B. Ensure that an x-ray is completed to confirm placement.
C. Check medication calculations with a second RN.
D. Make sure that the solution is appropriate for a central line.
B. Ensure that an x-ray is completed to confirm placement
,A nurse assess a client who has a radial ARTERY cathether. Which assessment will the nurse complete
first?
A. Amount of pressure in fluid container
B. Date of catheter tubing change
C. Type of dressing over the site
D. Skin color and capillary refill
D. Skin color and capillary refill
( An intra-arterial catheter may cause arterial occlusion, which can lead to absent or decreased
perfusion to the extremity.)
A nurse teaches a client who is being discharged home with a peripherally inserted central catheter
(PICC). Which statement will the nurse include in this client's teaching?
A. "Avoid carrying your grandchild with the arm that has the central catheter."
B. "Be sure to place the arm with the central catheter in a sling during the day."
C. "Flush the peripherally inserted central catheter line with normal saline daily."
D. "You can use the arm with the central catheter for most activities of daily living."
A. "Avoid carrying your grandchild with the arm that has the central catheter."
, (Rationale: A properly placed PICC (in the antecubital fossa or the basilic vein) allows the client
considerable freedom of movement. Clients can participate in most activities of daily living;
however, heavy lifting can dislodge the catheter or occlude the lumen. Although it is important to keep
the insertion site and tubing dry, the client can shower. The device is flushed with heparin.)
A nurse is caring for a client who is receiving an epidural infusion for pain management. Which
assessment finding requires immediate intervention from the nurse?
a. Redness at the catheter insertion site
b. Report of headache and stiff neck
c. Temperature of 100.1° F (37.8° C)
d. Pain rating of 8 on a scale of 0-10
b. Report of headache and stiff neck
(Rationale: Complications of epidural therapy include infection, bleeding, leakage of cerebrospinal fluid,
occlusion of the catheter lumen, and catheter migration. Headache, neck stiffness, and a temperature
higher than 101° F (37.8° C) are signs of meningitis and would be reported to the primary health care
provider immediately.)
A nurse assesses a client who had an intraosseous catheter placed in the left leg. Which assessment
finding is of greatest concern?
a. The catheter has been in place for 20 hours.
